I Want to be a Surrogate Mother

We’re thrilled that you’re interested in being a Surrogate Mother with Building Families. Before you fill in the form below, please make sure you review our Privacy Policy, Health Information Policy and meet the following qualifications:

If you meet these qualifications, please complete our contact form below.

Your Full Name *

City *

State *

Phone (format: ###-###-####)*

E-mail *

Height *

Weight (lbs.) *

Age *

Have you given birth to one or more children? *

Are you on Public Assistance? *

What type of public assistance?

Do you smoke/vape? *

List ALL medications you are currently taking *

Questions or Comments?

How did you hear about Building Families, Inc.? *

If a person or company referred you to Building Families, let us know so we know who to thank

Application Completion Reward

Completing our application process requires some work on your side, so we believe you should be rewarded for it! Here's how it works: Complete and submit this online for AND:

Return all requested documentation and schedule a home visit within 2 weeks ($150)

Complete and pass our psychological evaluation ($200)

Thank You!

Thank you for expressing interest in our Surrogacy Program. Your information has been received and forwarded to a Building Families, Inc. representative.

Due to the high volume of inquiries, please allow 7 to 10 days for a response. If you do not receive a response from us within that time, please contact our office at (949) 588-6015 or via e-mail at office@buildingfamiliesinc.com